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R&M,Work Order Store Number or City/State <br /> Attention Manager., <br /> >ds. Complete this form far every R&M invoice. . . <br /> Recard.the service call in the Repairs&.Maintenance Log... BIG SKY Work Order# <br /> stop' All invoices must include a completed R&M.WorkOrder form.an&;.: <br /> BIG SKY Work Order number to be considered for payment <br /> Use theB1G SKY Work Order number as the PO#on invoice 1 <br /> Service Company: ��, V ��; �([/►tL�TV Invoice/Service Ticket.Number: <br /> Technician Name: Date Work Performed: <br /> Detailed description of work pe ormed&equipment type: �G.i�� <br /> �G1 !Y Y- <br /> l�� <br /> Parts/Materials Used On Site Labor <br /> Quantity Description Start Time End Time . Total Hours <br /> L-15 .4L <br /> Stet'&Representative-Sign oture D to Store Representative-Print Name <br /> t hereby acknowledge the satisfactory completion of the above described work and further acknowledge <br /> the rnaterialrand time Involved are accurate as represented. <br /> Original Copy to Vendor/Invoice and Carbon Copy to Store Manager Love's C.orpgrate Office.- <br /> This <br /> ffice:This R&M Work Order(the"Work Order")and the Terms&Conditions printed on the reverse side of (800)388-0983 <br /> this document,shall govern your conduct,responsiblities,and obligations In relatlon to the services send Invoices to: <br /> provided,materlals used,or parts used. Vendor agrees that it has familiarized itself with and accepted PO 8ox26210 <br /> the terms of this Work Order,Including without limitation,the Terms&Conditions,and acknowledges Oklahoma City,4K 73126 <br /> Vendor's acceptance of same by its provision of services,materials or parts, or <br /> Love's R&M Work Order must accompany Invoice and.11en waivers(as per State requirements) e/m;APlnvoices@Loves.com <br /> �.to be considered for payment, <br /> fax:405-242-2611 <br /> RlEu;I.It E" io Ll <br /> AUG 9 2 2018 <br /> ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br />